| NPI | 1609210749 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CO DR.0057112) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NV DO3963) |
| Enumeration Date | 2013-04-19 |
| Last Update Date | 2025-12-24 |